The presence of thyroid peroxidase antibodies in Graves' disease is predictive of disease duration and relapse rates

Wahab, Furat; Kearney, E.; Joseph, Stonny

doi:10.1530/endoabs.31.p367

Cited by 4 publications

(3 citation statements)

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“…Other studies described that the presence of aTPO in GH patients resulted in a more aggressive disease pattern with higher relapse rate, mainly in females and younger age groups [8]. The underlying mechanism of the GH is T lymphocyte thyroid infiltration with B lymphocyte activation that leads to immune intolerance, as well as an increase in the synthesis and secretion of autoantibodies directed against the TSH receptor.…”

Section: Discussionmentioning

confidence: 99%

Levels of Antithyroid Antiperoxidase and Antithyroglobulin Antibodies in Patients with Graves Hyperthyroidism – Predictors of Initial and Sustained Remission and Consecutive Hypothyroidism

Stojkovska,

Manevska,

Makazlieva

et al. 2023

SEE J Immunol

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BACKGROUND: Initial and sustained remission is the principal objective in patients with Graves hyperthyroidism (GH) treated with antithyroid drugs (ATD). AIMS: Our study aimed to investigate the predictive value of antithyroid antiperoxidase (aTPO) and antithyroglobulin (aTg) levels on initial and sustained remission or consecutive hypothyroidism in subjects with GH treated with ATD. METHODS: Randomized, prospective, and longitudinal study during period 2013–2018 was performed. Eighty GH patients (thyrotropin [TSH] <0.01 mIU/L, free thyroxine [FT4] >30 pmol/L, triiodothyronine [FT3] >8 pmol/L), 59 females (73.75%), and 21 males (26.25%), aged 51 ± 12 years were included in the study. Subjects were divided into four subgroups (each with 20 patients) according to aTPO and aTg levels: Group I – no antibodies; Group II – (<500 IU/mL), Group III – (500–1000 IU/mL), and Group IV – (>1000 IU/mL). All subjects underwent 24 months of propylthiouracil treatment with follow-up of 24 months after remission (TSH >0.4 mIU/L, FT4 11–25 pmol/L, FT3 2.8–6.5 pmol/L). Blood samples were analyzed every 4 months. RESULTS: In Group I, 11 (55%) of the patients attained remission; during follow-up, 5 (45%) of them had disease relapse. In Group II, 12 (60%) attained remission and 5 (42%) had relapse. In Group III, 15 (75%) attained remission, 2 (13%) had disease relapse, and 4 (26%) developed hypothyroidism. In Group IV, 18 (90%) attained remission, 1 (5%) had disease relapse, and 9 (50%) developed hypothyroidism. Patients with values below 500 IU/mL attained remission in 60%, similar as the group without antibodies in 55% (p < 0.3). Patients in Group III and IV had significantly higher remission rates compared to Group I and II (p < 0.001). Baseline values of aTPO and aTg >1000 IU/mL were significant predictors of consecutive hypothyroidism (p < 0.05). CONCLUSION: Baseline aTPO and aTg values above 500 IU/mL were significantly prognostic for attaining and sustaining remission in GH and values above 1000 IU/mL were significant predictors of consecutive hypothyroidism.

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Section: Discussionmentioning

confidence: 99%

Levels of Antithyroid Antiperoxidase and Antithyroglobulin Antibodies in Patients with Graves Hyperthyroidism – Predictors of Initial and Sustained Remission and Consecutive Hypothyroidism

Stojkovska,

Manevska,

Makazlieva

et al. 2023

SEE J Immunol

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“…One study demonstrated positive anti-TPO Abs associated with aggressive GD and longer time to treat, especially in young female patients [ 19 ]. Moreover, no correlation was found between anti-TPO Abs positivity and GD outcomes, such as disease duration.…”

Section: Discussionmentioning

confidence: 99%

“…Anti-TPO Abs clinical significance in TED is not yet clarified, as some studies in children demonstrated an association of TED with certain anti-TPO Abs polymorphisms, while other studies in adults revealed that TED was associated with a low level of anti-TPO Abs titer [ 18 ]. Anti-TPO-Abs presence in GD could indicate a more aggressive disease that requires longer treatment, especially in the young female population [ 19 ]. Studies present that low titers of anti-TPO Abs in patients with GD and high TRAbs levels at the time of diagnosis are associated with TED [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

The Clinical Implications of Anti-thyroid Peroxidase Antibodies in Graves’ Disease in Basrah

Alhubaish¹,

Alibrahim²,

Mansour³

2023

Cureus

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BackgroundGraves' disease (GD) is an autoimmune disease, with thyrotropin receptor antibodies (TRAbs) being the most important cause in the pathogenesis. The aim of this study is to assess the clinical significance of anti-TPO Abs in GD. MethodsA retrospective study was conducted at the Faiha specialized Diabetes, Endocrine, and Metabolism Center (FDEMC) in Basrah during the period between December 2021 and December 2022. A total of 141 patients with GD were involved in this study, and of them, 97 (68.8%) were women. They were divided into two groups: patients with positive and negative anti-TPO Abs groups. ResultsPositive anti-TPO Abs were seen in 83 patients (58.9%) with GD. Pretreatment-free thyroxine level (ng/dL) was higher in the anti-TPO Abs positive GD patients than in those with negative antibodies (3.7±0.2 versus 3.0±0.2 with a p=0.021). Similarly, higher TRAb titers (IU/ml) at baseline were also seen in patients with positive anti-TPO Abs (9.8±0.7 versus 6.8±0.8) with a p=0.008. Giraffe appearance on thyroid ultrasound was more common in the group with positive anti-TPO Abs as compared to patients with negative anti-TPO Abs: 20 (87.0%) versus 3 (13.0%) with a p=0.005. A higher anti-TPO Abs titer (IU/mL) was associated with a baseline TRAb level of more than 6.4 IU/mL, and giraffe appearance on thyroid ultrasound (206.5±20.0 p-value<0.0001 and 228.0±35.3 p value=0.007, respectively). ConclusionA positive anti-TPO Abs in GD is associated with a high TRAb titer and free T4 level at baseline, as well as a giraffe appearance on thyroid ultrasound.

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Thyroid Receptor Antibodies and Thyroid Peroxidase Antibodies in a Sample Thyrotoxic Patients: A Cross-Sectional Study

Mahdi

Ashoor

Salman

2023

Mustansiriya Medical Journal

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Background: Thyrotoxicosis is a clinical status due to hypersecretion of thyroid hormones by diffuse goiter (Grave’s disease [GD]), multinodular goiter, single toxic adenoma, and pituitary adenoma secreting thyroid-stimulating hormone (TSH) rarely. GD: It is diffuse toxic goiter (GD) or (Basedow disease) it is a triad of: Diffuse toxic goiter, hyperthyroidism, and exophthalmos (proptosis). Aims: 1. Positivity of TRAb and TPO in thyrotoxic subjects. 2. Correlation of the titer of these antibodies with the clinical status of the patients. 3. Correlation between TRAb and TPO titer. 4. To find out if TPO titer on enrollment has any correlation with the clinical status of the patients. Methods: A cross-sectional study conducted in the National Diabetes Center–Mustansiriyah University in the period from November 2021 to April 2022 where 93 patients with GD are enrolled to check their thyroid status and check some biochemical variables in their sera as thyrotropin receptor antibody (TRAB), thyroid peroxidase (TPO) antibody, TSH, and free thyroxine (FT4). 44.6% are women and 35.7% are men, at the time of recreuitment 49.4% are toxic while the remaining 58.6% are euthyroid being on anti thyroid drugs. 87 persons are recruited as normal euthyroid, they are sex and age-matched, the control TRAb were negative. Results: GD patients are as follows: 54 (58.06%) euthyroid and 39 (41.94%) toxic at the time of recruitment. Eighty-two percent of toxic patients have goiter and 74.07% of euthyroid GD patients have goiter. Ophthalmopathy is found in (64.1% of toxic GD patients and 42.59% of euthyroid GD patients. TPO median in the control, toxic, and euthyroid GD patients is (22.76%), (75%) and (63.5%) (highest among toxic GD patients) (P < 0.001). TSH in the control group has a mean of (2.18 ± 1.72) and a median of (1.89). The TRAb is the highest in toxic GD patients, followed by euthyroid GD patients and the least in the control, its mean is (9.98 ± 8.42), (7.24 ± 7.8) and (0.93 ± 0.15), respectively. It is recommended to conduct a longitudinal study in which patients with GD are checked at variables times in the course of illness (remission and relapse) studying these biochemical and immunological markers in these variable states of thyroid function. Conclusion: Ninety-three thyrotoxic patients, 39 are toxic and 54 are euthyroid on arrival. Eye sings are more in toxic patients, goiter and eye signs are predictor of GD, TRAb is the highest among toxic patients, TPO are higher among GD patients versus the control.

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The presence of thyroid peroxidase antibodies in Graves' disease is predictive of disease duration and relapse rates

Cited by 4 publications

References 0 publications

Levels of Antithyroid Antiperoxidase and Antithyroglobulin Antibodies in Patients with Graves Hyperthyroidism – Predictors of Initial and Sustained Remission and Consecutive Hypothyroidism

Levels of Antithyroid Antiperoxidase and Antithyroglobulin Antibodies in Patients with Graves Hyperthyroidism – Predictors of Initial and Sustained Remission and Consecutive Hypothyroidism

The Clinical Implications of Anti-thyroid Peroxidase Antibodies in Graves’ Disease in Basrah

Thyroid Receptor Antibodies and Thyroid Peroxidase Antibodies in a Sample Thyrotoxic Patients: A Cross-Sectional Study

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